The Journal of Bone and Joint Surgery (American). 2008;90:875-880.
doi:10.2106/JBJS.G.00986
© 2008 The Journal of Bone and Joint Surgery, Inc.
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Scapulothoracic Fusion for Clavicular Insufficiency

A Report of Two Cases

Bassem Elhassan, MD1, Soo Tai Chung, MD1, Mehmet Ozbaydar, MD1, David Diller, BA1 and Jon J.P. Warner, MD1

1 Division of Shoulder Surgery, Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114. E-mail address for B. Elhassan: belhassan@partners.org. E-mail address for B. Elhassan: belhassan@partners.org. E-mail address for S.T. Chung: schung@partners.org. E-mail address for M. Ozbaydar: mozbaydar@partners.org. E-mail address for D. Diller: ddiller@partners.org. E-mail address for J.J.P. Warner: JWarner@partners.org
Investigation performed at the Division of Shoulder Surgery, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts

The first 150 words of the full text of this article appear below.


   Introduction
 
Scapulothoracic fusion is an uncommon procedure performed to stabilize the scapula to the chest wall. It is usually used to treat painful refractory winging of the scapula1-4, and it has been described principally in patients with fascioscapulohumeral muscular dystrophy, since tendon transfers in this population are usually unsuccessful2-8. Other indications include salvage of failed tendon transfer procedures to treat spinal accessory nerve palsy1,9,10 or long thoracic nerve palsy3,9-12. Additionally, disabling scapular winging secondary to loss of the medial clavicular strut support is a very rare indication that has not been reported previously. We report our experience with two patients in whom excision of the medial portion of the clavicle resulted in subsequent loss of scapular control and severe pain. Both patients were successfully managed with scapulothoracic fusion.


   Materials and Methods
 
Between 2000 and 2006, eight patients (ten shoulders) underwent scapulothoracic fusion at our institution. There were four men and four . . . [Full Text of this Article]


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